Organization Active NPI

Kidsconnect Pediatric Therapy, PLLC

  • Pediatric Occupational Therapist
  • Oak Park, IL
National Provider Identifier
1770165896
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
KIDSCONNECT PEDIATRIC THERAPY, PLLC
Practice address
1144 Lake St Ste 200B
Oak Park, IL 60301-1043
Phone
(708) 763-9582
Fax
(833) 523-2338
NPI assigned
Apr 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniella Nitzoy, OTR/LNPI 1902365414
Title
President/Occupational Therapist
Phone
(773) 474-1546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Environmental Modification Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XE0001X
Feeding, Eating & Swallowing Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XF0002X
Low Vision Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XL0004X
Mental Health Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XM0800X
Neurorehabilitation Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XN1300X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1144 Lake St Ste 200B
Oak Park, IL 60301-1043

Mailing address

729 Hayes Ave
Oak Park, IL 60302-1705
Phone (708) 763-9582

National Provider Directory

National Provider Directory

Locations

1144 Lake St
Ste 200B
Oak Park, IL 60301
Phone (639) 907-9165

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1770165896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 HAYES AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021705",
            "telephone_number": "708-763-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 LAKE ST STE 200B",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011043",
            "telephone_number": "708-763-9582",
            "fax_number": "833-523-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSCONNECT PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "NITZOY",
        "authorized_official_first_name": "DANIELLA",
        "authorized_official_title_or_position": "PRESIDENT/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "773-474-1546",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Low Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.